Based on the TOPAZ-1 study, do you now routinely include durvalumab in first line treatment of advanced bile duct cancer?

Is data sufficient to adopt this as the new standard of care?

Can you comment on the reported regional and race-based variations in outcomes? Should that data be utilized in determining treatment?

Answer from: Medical Oncologist at Academic Institution

YES! And it is a strong yes. TOPAZ-1 is a very elaborate study with statistically and clinically significant data outcomes. See Do et al., Journal of Clinical Oncology 2022. What is better than holding chemotherapy after 6 months and keeping patients on single agent durvalumab? And avoiding all...

Comments

Medical Oncologist at Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
NCCN Guidelines Version 1.2022 recommends Durvalum...

Answer from: Medical Oncologist at Community Practice

**I deleted the initial part of my answer to this question, as the TOPAZ-1 regimen has now been FDA-approved for treatment of metastatic biliary tract cancer.** It is notable also that much of the separation of survival curves in TOPAZ-1 happened after cessation of active therapy in the control...

Answer from: Medical Oncologist at Community Practice

The TOPAZ-1 study showed that the combination of durvalumab plus gemcitabine/cisplatin prolonged overall survival over gemcitabine/cisplatin alone in advanced biliary tract cancer, and was also well tolerated. Although the survival benefit of durvalumab in this setting is modest, I do think the data...

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Based on the TOPAZ-1 study, do you now routinely include durvalumab in first line treatment of advanced bile duct cancer?

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